This study traced the alcohol screening, brief intervention and referral to treatment (SBIRT) cascade in 139,532 US adults. It used National Survey on Drug Use and Health data from 2022 to 2024 with multivariable logistic regression. About 81% reported past-year health care use, and 69% of these reported alcohol screening. Only 4% of heavy drinkers reported a brief intervention, against 33% of those with severe alcohol use disorder (AUD). Women were less likely than men to receive brief intervention (marginal prevalence ratio 0.52) or, with AUD, referral (0.62). All cascade steps rest on self-report in a cross-sectional survey.
Why it is interesting: The cascade shows where alcohol care drops away: screening is common but follow-up is rare. Women, adults aged 50 and over, and Hispanic and Black adults are reached less often at certain steps.
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